PROJECT SUMMARY/ABSTRACT Changes in the healthcare delivery system brought about nationally by the Affordable Care Act and the Mental Health Parity and Addiction Equity Act have expanded substance use disorder (SUD) treatment beyond specialty care, and integrated it into primary care and acute care medical settings where SUD prevalence rates are high. There is an increased need for future research to develop and test the effectiveness of SUD interventions implemented in healthcare settings and linked to specialty SUD treatment programs. The NIDA National Drug Abuse Treatment Clinical Trials Network (CTN) has prioritized this need, as it faces an opioid epidemic, resurgence of methamphetamine, and co-occurring substance use and mental health and physical disorders. In order to contribute to the CTN's expanded objectives and research priorities, the Pacific Northwest (PNW) Node proposes the following Specific Aims: (1) Increase the capacity of the PNW Node research team by adding investigators with demonstrated practical and research expertise addressing opioid use dependence, other substances of abuse, co-use of substances, implementation of novel behavioral and pharmacological treatments, primary care practice-based research networks, collaborative care models, integration of behavioral health and SUD treatment components into primary and acute care settings, and harmonizing electronic medical record systems across multiple health care systems; (2) Expand the scope, population, diversity, and focus of the PNW Node?s roster of research, clinical practice, and dissemination settings by including a number of large state-wide and regional practice-based primary care clinical and research networks involved in integrated behavioral health collaborative care; (3) Design and conduct pragmatic, comparative effectiveness, registry, and other types of innovative studies, informed bidirectionally by SUD researchers, clinicians, primary and acute care providers, and enhanced by use of electronic health records (EHRs), that implement and evaluate integrated behavioral and pharmacological treatments for illicit- and misused prescription opioids, methamphetamine, and alcohol; (4) Provide information dissemination, training and technical assistance to affiliated health care and SUD providers, researchers, and the public about opioid use disorders, other SUDs, collaborative care and chronic disease management models, the integration process, and linkage between primary care and specialty SUD programs through the CTN National Dissemination Library, the Northwest Addiction Technology Transfer Center, the UW Alcohol and Drug Abuse Institute, the WSU Rural Mental Health and Substance Abuse Center of Excellence, and the Center for Rural Opioid Prevention, Treatment, and Recovery.